Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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The 4 Main Reasons We Fail Reforming Health Care: Cost Fears, Variation, Poor Collaboration and Understanding

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Approximately 2/5 persons don't understand their insurance coverage, i.e., which healthcare services are being covered under their current plan and, 1 in 5, "have avoided visiting a doctor for a general health concern within the past 12 months because of cost concerns."

Opportunity for Real Reform

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We are now in an unprecedented opportunity for change, but Robert H. Brook, MD, ScD* warns that simultaneously improving health care coverage, the affordability of health care and its quality is challenging.

Heart's Not Healthy? Recouping Tips

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When it comes to health, the better-informed patient does better—Duh! What is a patient to do to reverse or ameliorate heart failure, that is, besides taking meds? ABSTRACT Context Little is known about the effects of low health literacy among patients with heart failure, a condition that requires self-management and frequent interactions with the health care system.

My Patients ARE Sicker; They Need Extra Care!

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The common retort when confronted with the escalating cost of care and unexplained variation is: "But, my patients are sicker! Southerland, Fisher and Skinner in "Getting Past Denial — The High Cost of Health Care in the United States," are again observing their mentor, Jack Wennberg's dictum, written about extensively at the end of the last century and earlier, that the cost differences between regions and practices may be unwarranted.

Waste Less; Add Value

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To make health care reasonably profitable for private payers and more affordable for patients, those who manage health care must focus on reducing cost, which is far easier than increasing the health benefit or medical loss ratio.

The Business Opportunity of Medicine

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The practice is getting squeezed; Want ideas? First, don't give up on the idea that small practices are out.  Consider them, if for no other reason then they are often better then large pracices that are overly driven to see large volumes of patients. IOW, solo and small practices are still playing an important role, although they may require TLC to thrive.

The Managed Care-Pharma Interface-Part III: the Pitfalls and the Promise

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Medication Adherence and the Pharmaceutical & Med. Manufacturing (PMM) industry--an opportunity for synergism with health care. "At the same time that unprecedented progress in pharmaceutical research and development is producing new and better medicines for the treatment and prevention of disease – people are asking tough and legitimate questions about the role and responsibility of the pharmaceutical industry in expanding access to the results of this research."

Patient-Centered Caring

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Achieving patient-centered care is difficult, yet essential; since paternalism is out, the patient has a greater role to play. The editorial, "Patient-Centered Care; What Is the Best Measuring Stick?" by Drs.